| NPI | 1982730909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: FL ME143249) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: GA 98450) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: TN 77579) | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2026-08-31 |